NAD + supplementation normalizes key Alzheimer’s features and DNA damage responses in a new AD mouse model with introduced DNA repair deficiency
Open accessAbstract
Emerging findings suggest that compromised cellular bioenergetics and DNA repair contribute to the pathogenesis of Alzheimer’s disease (AD), but their role in disease-defining pathology is unclear. We developed a DNA repair-deficient 3xTgAD/Polβ +/− mouse that exacerbates major features of human AD including phosphorylated Tau (pTau) pathologies, synaptic dysfunction, neuronal death, and cognitive impairment. Here we report that 3xTgAD/Polβ +/− mice have a reduced cerebral NAD + /NADH ratio indicating impaired cerebral energy metabolism, which is normalized by nicotinamide riboside (NR) treatment. NR lessened pTau pathology in both 3xTgAD and 3xTgAD/Polβ +/− mice but had no impact on amyloid β peptide (Aβ) accumulation. NR-treated 3xTgAD/Polβ +/− mice exhibited reduced DNA damage, neuroinflammation, and apoptosis of hippocampal neurons and increased activity of SIRT3 in the brain. NR improved cognitive function in multiple behavioral tests and restored hippocampal synaptic plasticity in 3xTgAD mice and 3xTgAD/Polβ +/− mice. In general, the deficits between genotypes and the benefits of NR were greater in 3xTgAD/Polβ +/− mice than in 3xTgAD mice. Our findings suggest a pivotal role for cellular NAD + depletion upstream of neuroinflammation, pTau, DNA damage, synaptic dysfunction, and neuronal degeneration in AD. Interventions that bolster neuronal NAD + levels therefore have therapeutic potential for AD.
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NMN and NR protect against diabetes, Alzheimer disease, endothelial dysfunction, and inflammation.
“NMN and NR demonstrated protect against diabetes, Alzheimer disease, endothelial dysfunction, and inflammation.”
From NAD+ Precursors Nicotinamide Mononucleotide (NMN) and Nicotinamide Riboside (NR): Potential Dietary Contribution to Health (2023) · cites this paper as [24]
The Discussion (p. 7) reports that NR improved several Alzheimer-like features, including neuroinflammation, in mouse models; it also cites animal-model findings for NMN and Alzheimer-related outcomes. The paper does not establish protection against diabetes or endothelial dysfunction, and its inflammation finding is specific to neuroinflammation in the Alzheimer mouse models. (LLM, conf=0.88)
Experimental — accuracy not yet measuredNR significantly reduced neuroinflammation, hippocampal neuron apoptosis, phosphorylated Tau, and DNA damage, while increasing neurogenesis by almost 20%.
“Futhermore, NR significantly reduced neuroinflammation, apoptosis of hippocampal neurons, phosphorylated Tau and DNA damage, while also increasing neurogenesis by almost 20% [24].”
From NAD+ Precursors Nicotinamide Mononucleotide (NMN) and Nicotinamide Riboside (NR): Potential Dietary Contribution to Health (2023) · cites this paper as [24]
The Results (pp. 6–7) report reduced phosphorylated Tau, DNA damage, and apoptosis after NR treatment; the Discussion (p. 7) reports reduced neuroinflammation. The Results (p. 4) also report increased proliferation of neuronal progenitor cells, but our copy does not give an almost-20% increase in neurogenesis. The findings concern AD mouse models and cultured mouse cells, rather than an unqualified effect. (LLM, conf=0.88)
Experimental — accuracy not yet measuredNR protects cognitive function, synaptic plasticity, learning, memory, and motor function in Alzheimer disease models.
“NR demonstrated protective effects on cognitive function, synaptic plasticity, learning, memory, and motor function in Alzheimer’s disease models [24, 27].”
From NAD+ Precursors Nicotinamide Mononucleotide (NMN) and Nicotinamide Riboside (NR): Potential Dietary Contribution to Health (2023) · cites this paper as [24]
NAD+ supplementation normalizes key Alzheimer's features and DNA damage responses in an Alzheimer's disease mouse model.
“NAD+ supplementation normalizes key Alzheimer’s features and DNA damage responses in an AD mouse model [74].”
From Integrated analysis of ultra-deep proteomes in cortex, cerebrospinal fluid and serum reveals a mitochondrial signature in Alzheimer’s disease (2020) · cites this paper as [74]
AD mouse models with Polβ heterozygosity feature defective DNA repair and show increased synaptic and cognitive deficits, neuronal dysfunction and cell death.
“AD mouse models with Polβ heterozygosity feature defective DNA repair and showed increased synaptic and cognitive deficits, neuronal dysfunction and cell death [502].”
From Molecular and cellular mechanisms underlying the pathogenesis of Alzheimer’s disease (2020) · cites this paper as [502]
In Alzheimer's disease mouse models, supplementation with NAD+ precursors improves synaptic plasticity and neuronal morphology.
“Supplementation with NAD+ precursors has been shown to improve synaptic plasticity and neuronal morphology in AD mouse models (Fang et al., 2019; Hou et al., 2018).”
From NAD+ in Brain Aging and Neurodegenerative Disorders (2019) · cites this paper as Hou et al., 2018
In neurons, base excision repair, the main pathway for repairing oxidative DNA damage, is reduced in elderly humans and in Alzheimer's disease patients.
“In neurons, BER, the primary pathway for the repair of oxidative DNA damage, is reduced in elderly humans and in AD patients (Hou et al., 2018; McKinnon, 2013).”
From NAD+ in Brain Aging and Neurodegenerative Disorders (2019) · cites this paper as Hou et al., 2018
Nicotinamide riboside treatment also improved neurogenesis and proliferation of neural progenitor cells in a BER-defective 3xTg Alzheimer's disease mouse model.
“NR treatment also improved neurogenesis and proliferation of neural progenitor cells in a BER-defective 3xTg AD mouse model (Hou et al., 2018).”
From NAD+ in Brain Aging and Neurodegenerative Disorders (2019) · cites this paper as Hou et al., 2018
In Alzheimer's disease mouse models, supplementation with the NAD+ precursor nicotinamide riboside inhibited disease-associated neuroinflammation, decreased numbers of activated microglia and astrocytes, and reduced pro-inflammatory cytokines.
“In AD mouse models, supplementation with the NAD+ precursor NR inhibited the disease-associated neuroinflammation, decreased the numbers of activated microglia and astrocytes, and reduced pro-inflammatory cytokines (Fang et al., 2019; Hou et al., 2018).”
From NAD+ in Brain Aging and Neurodegenerative Disorders (2019) · cites this paper as Hou et al., 2018
In a BER-defective 3xTgAD/Polβ+/− mouse model, nicotinamide riboside supplementation reduced DNA damage, as evidenced by reduced γH2AX staining (marking DNA double-strand breaks) in the hippocampus.
“In a BER-defective 3xTgAD/Polβ+/− mouse model, NR supplementation reduced DNA damage as evidenced by reduced γH2AX staining (marking DNA DSBs) in the hippocampus (Hou et al., 2018).”
From NAD+ in Brain Aging and Neurodegenerative Disorders (2019) · cites this paper as Hou et al., 2018
In rodent models of early-onset familial Alzheimer's disease, brain NAD+ depletion and metabolic dysfunction have been demonstrated.
“In rodent models of early-onset familial AD, brain NAD+ depletion and metabolic dysfunction have been demonstrated (Dong and Brewer, 2019; Hou et al., 2018).”
From NAD+ in Brain Aging and Neurodegenerative Disorders (2019) · cites this paper as Hou et al., 2018
NAD+ augmentation inhibited Alzheimer's disease-related pathology and cognitive decline in different AD animal models, including 3xTgAD mice treated with nicotinamide, 3xTgAD/Polβ+/− mice treated with nicotinamide riboside, and neuronal Aβ1-42 and Tau transgenic C. elegans models.
“Accordingly, NAD+ augmentation inhibited AD-related pathology and cognitive decline in different AD animal models, including 3xTgAD mice treated with NAM (Liu et al., 2013), 3xTgAD/Polβ+/− mice treated with NR (Hou et al., 2018), and in neuronal Aβ1–42 and the neuronal Tau (pro-aggregant F3ΔK280 tau fragment) transgenic C. elegans models (Fang et al., 2019) (summarized in Table 1).”
From NAD+ in Brain Aging and Neurodegenerative Disorders (2019) · cites this paper as Hou et al., 2018
Second, NAD+ augmentation inhibits neuroinflammation in Alzheimer's disease mice.
“Second, NAD+ augmentation inhibits neuroinflammation in AD mice (Hou et al., 2018).”
From NAD+ in Brain Aging and Neurodegenerative Disorders (2019) · cites this paper as Hou et al., 2018
Third, NAD+ augmentation restores neurogenesis in Alzheimer's disease mice by promoting the proliferation of neural progenitor cells.
“Third, NAD+ augmentation restores neurogenesis in AD mice by promoting the proliferation of neural progenitor cells (Hou et al., 2018).”
From NAD+ in Brain Aging and Neurodegenerative Disorders (2019) · cites this paper as Hou et al., 2018
NAD+ precursors NR and NMN improve neuronal cell health, memory and cognitive function in rat and mouse models of Alzheimer disease, and show neuroprotective properties in Drosophila models of Parkinson disease and mouse models of ALS.
“the NAD+ precursors NR and NMN improve neuronal cell health, memory and cognitive function in rat and mouse models of Alzheimer disease136,161,175–180, and also showed neuroprotective properties in Drosophila melanogaster models of Parkinson disease181,182 and in mouse models of ALS139.”
From NAD+ metabolism and its roles in cellular processes during ageing (2021) · cites this paper as [175]
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Ageing as a risk factor for neurodegenerative disease
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Self-citationNAD+ metabolism and its roles in cellular processes during ageing
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Self-citationTherapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence
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NAD+ in Brain Aging and Neurodegenerative Disorders
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NAD metabolism: Implications in aging and longevity
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Urolithin A improves Alzheimer's disease cognition and restores mitophagy and lysosomal functions
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Contributions of DNA Damage to Alzheimer’s Disease
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Microglial mitophagy mitigates neuroinflammation in Alzheimer's disease
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“After 10 min, the mice were returned to their housing cages (Hou, 2018; Iaccarino et al, 2016).”
NAD+ hydrolase Sarm1 is a key driver of synapse degeneration and memory loss in Alzheimer’s disease
Fan, F., Joshi, P., Liu, X., Kotturu, S. K., Abiola, M., Liu, Q., & Lou, X. (2025) · doi:10.64898/2025.12.21.695860
- Authors
- Hou, Y., Lautrup, S., Cordonnier, S., Wang, Y., Croteau, D. L., Zavala, E., Zhang, Y., Moritoh, K., O’Connell, J. F., Baptiste, B. A., Stevnsner, T. V., Mattson, M. P., & Bohr, V. A.
- Affiliations
- National Institutes of Health (US)
- Aarhus University (DK)
- University of Copenhagen (DK)
- ORCID
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2018-02-05
- Volume
- 115
- Issue
- 8
- Pages
- E1876-E1885
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC5828618
- OpenAlex
- W2793585092
- Cited by
- 472
- References
- 71
- Citations by year
- 2026: 50 · 2025: 57 · 2024: 56 · 2023: 58 · 2022: 58 · 2021: 67 · 2020: 70 · 2019: 39 · 2018: 17
- FWCI
- 33.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Funders
- HHS | NIH | National Institute on Aging (ZIA AG00073517)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Geriatrics and Gerontology › Sirtuins and Resveratrol in Medicine
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- Alzheimer's disease, NAD+ supplementation, nicotinamide riboside, DNA repair deficiency, DNA damage response, phosphorylated tau, neuroinflammation, neuronal apoptosis, SIRT3, brain energy metabolism, synaptic dysfunction, hippocampal synaptic plasticity, cognitive impairment, amyloid-beta
- MeSH terms
- Alzheimer Disease, Animals, Disease Models, Animal, DNA Damage, Gene Expression Regulation, Male, Mice, Transgenic, NAD, Niacinamide, Pyridinium Compounds, tau Proteins, Sirtuins, Mice, Neurogenesis, Sirtuin 3, Cognitive Dysfunction
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